Week 2: Kumasi

Sunday, May 12th:

Church again today was wonderful. I know I mentioned it last Sunday, but the energy I feel from the members is astounding. Their testimonies are powerful. Ghana is primarily Christian and there is no shortage of churches to attend. The walk to church is filled with the sounds of other churches: very loud music playing on speakers and lots of yelling into microphones.

We left after sacrament meeting to finish packing up. We said goodbye to the others and it sorta hit me how much I’ll miss them. It’ll just be me, Gabby, and a guy named Christian for the next three weeks. I’m just grateful I won’t be completely alone.

After a five hour drive, we arrived in Kumasi! Our driver, Francis, is veryyy liberal with his horn and hits the speed bumps pretty hard, but that didn’t stop me from sleeping pretty much the entire time. The doctor was there to meet us at the clinic when we arrived. His house is above it and our place is above that. It’s a gorgeous place and is definitely an upgrade from the hotel (especially since it’s free!)

The view from our front door

The doctor’s name is Seth Wanye and he grew up here in Ghana. He went to med school in Russia where he met his wife Katya, so he also knows Russian in addition to Twi, English, and a couple other Ghanaian dialects. I tried desperately to remember any of the Russian I know, but my mind was blank except for “eta stol”, which means “this is a table”. Super helpful.

We didn’t need dinner because we’d had a big lunch on the way up, so the three of us just sat on the couches and talked and bonded and such. We also got a modem (basically a portable router) so we have wifi in the room! I FaceTimed my mom for the first time and wished her a happy Mother’s Day. I know that every kid says they have an amazing mom, but I really feel like I lucked out big time. 

I was too lazy to go outside and turn on the water pump, so I took a shower with a dribble of water from the shower head. Not ideal, but it works. I’m also grateful Gabby stole a blanket from the airplane on her flight over here because that’s what I’m using as my blanket tonight. I was a little nervous to come up to the north, but so far it seems like it’ll be great.

Monday, May 13th:

I guess the AC actually works here? Because it was cooold last night. I got up in the middle of the night to put on my sweats and flannel (two things I thought I’d brought for nothing) in an attempt to warm up and that definitely helped.

As I've talked a little bit about before, Unite for Sight is partnered with five local eye clinics in Ghana and volunteers are assigned to several different ones throughout their stay. Last week, I was with Crystal Eye Clinic in Accra and now I'm with Friends Eye Centre! I'll spend one week here in Kumasi and then the following two weeks (with Friends still) in Tamale where they have another clinic.

The driver said he’d be here at 6:30, and I was surprised when he was actually pretty close to being on time! One thing in our pre-internship training that was reiterated over and over again was Ghana’s use of “elastic time”. In the U.S., punctuality is something that’s valued deeply. If you have an appointment at 2:00, you arrive five minutes early to make sure you’re not late. “Elastic time”, however, (as the name implies) is more fluid. If the driver says he’ll be there at 7:30, you might leave at 8:00 or even 8:30. This is something I’m glad I’d read about before coming here because otherwise, I could see myself getting kind of frustrated with the lack of punctuality. It’s not that they don’t care, it’s simply that Ghana moves at a slower, more relaxed pace.
 

The drive today was less than an hour! It would have been longer, but Francis (the driver) honked his horn about once every other second (I’m not exaggerating) to alert the other drivers that the other drivers could move for him. Because he was driving down the middle of the street. Between the two opposing lanes of traffic.  I was shocked. And a little stressed. Here’s a picture we took to document it.

We beat all the other traffic so I guess I can't complain

The outreach today worked a little differently than I was used to. When we arrived, there wasn’t a group already waiting for us. Instead, we set up shop on the side of the road and simply waited for people to walk by and come get an eye exam. With just three of us, we had one doing eye exams, one at the dispensing table, and one shadowing the ophthalmic nurse doing the eyes exams. I was put on the eye testing again, which is fine because I think that’s my favorite station. However, because we were waiting for people to come to us, there were a lot fewer patients and a lot more downtime. It started raining at one point, so we decided to pack up. The rain then cleared (of course) so we unpacked the van again and continued working. We worked from 8:00-1:30 and only saw a little over 50 patients, a sharp contrast to the ~200 we’ve been seeing on other outreaches.

Gabby and AK hard at work at the dispensing table

The area before we set up 

The spread

I slept like a rock, so I have no idea how long the drive was, but when we got back it hit me how hungry I was. We went inside and I was about to feast on granola bars when someone came upstairs and told us lunch was ready. I knew the doctor had someone that prepared meals for him and his family, but I didn’t know she would be preparing them for us too. I about cried when I saw the spread that lay before us: mangoes, fufu and soup, soda, juice, rice, and chicken. Everything tasted so good, even the fufu! Thank you, Gladys <3

We spent the rest of the day reading and doing homework assignments for the classes we’re taking. Grateful for the bit of downtime we have because this miiight be the first time I’ve worked on homework since getting here. We ended the night with a movie and working wifi and it was wonderful.

Tuesday, May 14th:

Our driver came at 6:00 this morning, which means I was up early enough to see my first Ghanaian sunrise. Because Ghana is so close to the equator, the sun both rises and sets at 6:00 year-round. It’s nice because if it’s getting dark (or light), you automatically know what time it is.

Along the way, we bought apples and boflot (the Ghanaian doughnut thing) and twas a lovely breakfast indeed. I can't really tell what those things are actually called? I've heard boflot, bofrot, boflof, etc, so I'm just gonna stick with boflot and hope that they understand what I'm saying.

The cute little boflots being fried

We set up camp at a church in a town called Brofoyedru. Slowest day by far. We had a whopping nine patients. The staff explained that there are a lot more eye clinics in the area, so outreaches like ours are more common. Apparently there had just been one there last week, which maybe explains the low attendance. I was stationed with Josiah today, watching him perform the eye exams, and he was really good at explaining what was happening with each patient. I learned more about glaucoma and cataracts and he even let me use his ophthalmoscope!

We got FanIce on the way home and I tried the chocolate flavor, which is officially my new favorite. I’ve gotta find a way to bring these to America because I’ve already developed an addiction.

Just look at the joy FanIce brings

When we arrived home, Gladys hooked it UP again with an amazing meal. Probably one of the best I’ve had yet: rice, fried plantains, this bean stew-esque concoction, chicken, juice, and mangoes. I think she thinks we’re gonna eat about 3x the amount we actually do because there was so much food leftover. We took it upstairs and later ate some of it for dinner.

A very typical street. They all have these
weirdly deep gutters on either side

Wifi is finnicky, even with the modem we have, and it eats up cedis like no other. I bought another 20 cedis worth of credit today and we went through most of it in a couple hours. We’re gonna have to figure out a way to ration it better. Our night was spent playing Wordscapes (because you can play it on airplane mode) and swapping funny dating stories. There was also an intense rainstorm we got to watch from our balcony. The power went out for a bit, which isn’t too bad except that the AC turns off too. Luckily, it usually turns on again pretty soon.

I was doing the math and with today being day 11, that means I’m already more than a quarter of the way through this trip! For as long as every day feels, I’m amazed at how fast it’s going.

Aww, Gabby fell asleep playing Wordscapes

Wednesday, May 15th:

They didn’t tell us what time we would be leaving today, so we figured we should wake up at 5:30 so that we could be ready to leave at 6:00. We didn’t actually leave until 6:45, but that gave us extra time to drink all the Milo we wanted. And more time to catch the massive cockroach we saw in the living room.

Stops for mango are a priority

Today we went to a place called Aboabo. We saw more patients than yesterday luckily, but it was still only about 20. I was stationed at the dispensing table with the optician, Amoah-Kwakye (AK for short) and the day was filled with good conversation and learning about which medicines are prescribed when. He taught me more Twi and we both laughed over my bad pronunciations. He also taught me about good Ghanian manners / etiquette (I accidentally handed change back to a patient with my left hand, oops) and about health care in Ghana. AK is super passionate about the gift of sight and his enthusiasm and empathy were contagious.

You can always tell when school gets out because the streets are suddenly flooded with kids in uniform all walking home. It’s the best when they come over to investigate and you get to see which child is the bravest and will approach you first. Today a girl named Precious was the first to cave and then they all rushed over and took turns giving us high fives. I can confidently say that will never get old.

Any mention of the word "picture" and they all strike their best pose

Gladys again prepared an amazing meal and we again ate more than we should have. She made mashed yams that tasted exactly like mashed potatoes and we were in heaven. I remember before coming here I was thinking I might lose some weight while I’m here, but I realize now how wrong I was, especially considering the amount of oil they use in all the food.

I’m starting to get a little antsy just staying in the house after we get home every day, but it’s hard because there isn’t much within walking distance where we are. I’m hoping tomorrow we can go find something fun to do and take advantage of our last few days in Kumasi.

Thursday, May 16th:

Today we went back to the same place we were at on Monday! Before we got started, Gabby and I went hunting for some boflot on the street. Though we didn’t find any, we did find mazes of narrow little alleyways, PACKED with people and the goods they were selling. It was unlike any environment I’ve ever been in before. I wish I’d gotten a better picture, but I always feel a little weird (like I’m fulfilling all my white person stereotypes) every time I take a picture of something. We found a woman selling pineapple and we each bought one from her. It’s mesmerizing to watch the women cut up the fruit you buy from them. They clearly spend all day doing it.

One of the less crowded alleys

I sat with Josiah again as he performed the eye exams today! I’ve had a lot of questions about the eye and he seemed willing to answer them, so any spare time in between patients was spent learning about the eye and its diseases. He drew diagrams and told stories and I learned more today about the eye than all the other days combined. I might do a blog post on just everything I learned today because it was fascinating to see the diseases we see here contrasted with what I know about eye problems in the U.S.

I was grateful to have a fairly constant stream of patients today (we saw about 60, the most this week) because it makes the day go by so much faster. After getting back home, we ate an early dinner of salad that had a ton of avocado in it (which oddly enough, they call pear here?) so I was on cloud nine. We also had fufu with palm nut soup and lots of fruit.

Though we had plans to go adventuring today, we got back later than usual, and everyone was super tired. I don’t even remember falling asleep, but suddenly I was waking up and it was almost 8:00. Whoops. I came out into the living room and joined my studious flatmates in doing homework and writing papers. We got a new router today and the wifi is so much better. It's a game changer. But also now we don't have an excuse to not do our homework.

Contact Gabby Sutton for all your cockroach needs

Gabby and I (okay, just Gabby) spent a fair amount of time trying to catch a huuuge cockroach (the one we saw the other day) that was loose in the house. I was cracking up as she went “Steve Irwin” on the creature. At one point, it flew directly at her face and she screamed and I was super grateful she is so much braver than I. After several disappearing acts, we (she) trapped the thing under a metal jar. It sits there still, as we are a bit unsure of what to do with it. Once we locate some paper, we’ll probably release it back into the wild to live its life.  UPDATE. AS I’M WRITING THIS ANOTHER ONE JUST APPEARED. Okay, gonna go play cockroach catcher (or rather, emotional support for the cockroach catcher).

Friday, May 17th:

Thanks to the cockroach(es), we went to bed pretty late, about 2:00. We woke up at 5:30 to be ready by 6, but we didn’t end up driving away until after 8:00. I’ve rediscovered podcasts in the last couple days though, so I’ve been doing a lot of that in my spare time. I know I should be doing homework, but there's something so exhilarating about procrastinating assignments until the last minute. 

Today we set up shop at the Kumasi Mall where they were having some sort of outdoor market type thing. I think it was put on by a TV station? At one point our group was interviewed so that’s my guess. With a fairly constant stream of patients, the day went by quickly again. I was with AK at the dispensing table and by the end he basically had me running it (which was a pretty good feeling to be honest). I think the hardest part of the job is deciphering the doctor’s handwriting on the note. Once you can do that, the rest isn’t too bad. I’m at a point now where I would know how to prescribe reading glasses and (more or less) which drugs do what.

A patient getting their eyes examined with a handheld slit camera

Christian and I manning the dispensing table

In our downtime, we watched Gabby try to dance, took pictures of staff sleeping, wrote our names in different fonts, took selfies, and watched AK draw a portrait of Gabby in just a couple of minutes. Maybe I shouldn’t say all that because it sounds like we were just goofing off the whole time, but this was over the course of a whole day so it’s really not thaaaat bad.

Selfie with AK

We ate dinner (spaghetti and potatoes with egg) and had the chance to talk to Dr. Wanye for a bit. He informed us of a change of plans. He just found out he has to go to Accra early next week, so we won’t leave for Tamale until Wednesday at the earliest. A little sad, but that means now we have time to (hopefully) do a couple touristy things before we leave.

We also ended up talking to Dr. Wanye about the health care situation in Ghana. He said the biggest problem lies in the insurance companies. He explained how the insurance companies are usually somewhere between 3-6 months behind in reimbursing clinics for their services. This means that the clinic is forced to buy things several months in advance, hoping that by the time the pharmaceutical companies want their money back and drugs paid for, the insurance companies will have reimbursed him. You can imagine how stressful this would be. It’s a situation that forces a lot of doctors into debt that they can’t come back from.

Dr. Wanye then explained a little bit about infrastructure here in Ghana. He said that when someone decides they want to build a house, they will first save up to buy a plot of land. After they do that, they will buy the land and then start saving for the blocks (every structure here is made out of cinder blocks). After buying the bricks, then you’ll start saving for the money to build the foundation. Then you’ll put in the plumbing and the electrical and such. He said building a house here usually takes 6-7 years. Which explains a lot actually! Everywhere we go, there are half-built buildings that appear to be abandoned. I guess maybe they’re actually just in the middle of being built! It’s a very different attitude from the U.S. where it’s sort of the opposite: build the house even if you don’t have a ton of money and then just pay the debt afterward. Gave me a lot to think about.

I went back upstairs to the apartment where I found Gabby trying desperately to shower with our broken shower head. It was actually pretty hilarious. Until I had to do it too of course. I was basically on all fours on the floor of the bathtub, trying to make sure I got all the conditioner out of my hair. I’ve realized here in Ghana, you just make whatever you have work.

Gabby showering. I've added some arrows to show where the stream of water was

We ended the night by doing a little homework and trying to catch the cute little lizard under my bed.

Saturday, May 18th:

I guess the thing at the Kumasi Mall is some sort of weekend-long market gig because that’s where we went again today. There were a few patients waiting for us when we arrived, so we quickly unpacked and got to work. I was at the visual acuity station for the majority of the day and luckily it was mostly in the shade. We also got polos so now we’re ~officially~ a part of the team.

So classy

We all took turns going to the grocery store inside for snacks and drinks and such. While inside, I saw several other obronis! It was hilarious to me that it was so jarring to see another white person. Even so, I still spotted several people sneaking pictures of me. There’s the “take a picture of your friend with the person of interest in the back” or the classic “take a selfie with the person of interest in the back”. I think mostly it’s funny because people think they’re being so subtle. It’s getting a little old though. If you really need a picture of me, just do it blatantly. I’m starting to feel the same about the language barrier. Someone will speak to me in Twi and I’ll just stare at them blankly as I try to register what’s going on (especially since people are often speaking English, just with a thick accent that takes a while to decipher). When they realized I don’t speak Twi, they think it’s really funny to keep talking to me and watch me be confused. Understandable I guess, but I’m becoming increasingly motivated each day to learn more of the language.

Work today was much like the day before. We saw a little over 60 patients and I was very sweaty.

A patient getting an eye exam

Francis, our driver

Gabby found a woman in the market who made clothing, so she decided to get measured and have a dress made. After less than two hours, it was done! And it cost somewhere around $13. I’ve decided I’m going to need to do that before I leave Ghana. (Side note, if anyone wants a specific souvenir like a painting or bracelet or such, let me know. There is no shortage of places to buy stuff here.)

Gabby took this picture of me when we got back from working and I feel it captures the moment well.

We were home by 4:30 so we had a little bit of time to relax before going down to dinner. We ate with Dr. Wanye again and he told us about some of the research he’s conducted while working as an ophthalmologist. His work has mostly been with Trachoma, a disease that roughens the other side of your eyelids, which leads to corneal scarring and eventual blindness. Though it’s not super common in the U.S., it’s the leading cause of preventable blindness worldwide and is endemic in Ghana. With just a single dose of antibiotics, the infection is gone. He talked about an experiment he led in several communities where he handed out mass antibiotics. Before starting, 11% of people had the disease. After five years, that level was down to about 2%. If it’s below 5%, it’s no longer a major public health concern. This man is so inspiring!

We also talked a bit about the prevalence of malaria. Apparently, there’s research being done to create a malaria vaccine. Dr. Wanye explained to us just how life-saving that would be. When I asked if he’d had Malaria before, he busted up laughing. “Of course I have. Many times. So has my wife. And my children. That’s the way it goes here.” He told us he always has the medicine stocked in the house and when they start to show the tell-tale signs, they take it. Not so many people are so well off though, financially or educationally. Many people don’t go to the doctor until they are in critical condition. In children, malaria can even cause convulsions and mental retardation. When malaria progresses that far, the treatment is more drastic, and the side effects of the medicine can be intense. In children, the quinine they use to treat it can even cause blindness. Desperate mothers show up to Dr. Wanye's clinic, hoping that the situation can be reversed. I can’t imagine how difficult that would be, narrowly escaping one disease only to be plagued with something so drastic for the rest of your life.

We're all going to bed pretty early because we are exhausted. I'm excited for the reset that Sunday brings.